The steps of IMCI introduction to countries

1
The steps of IMCI introduction to countries

• Initial contact to provide information
• Information/orientation meetings
• Training of key MOH staff
• Establishment of an IMCI management and
  coordination group
• MOH endorsement

2
Early implementation

• Development of a training plan or strategy
• Adaptation of clinical guidelines
• Selection of initial districts
• Training of national-level facilitators
• Preparation and planning at district level
• Training of district-level facilitators
• First training of health workers
• Follow-up of trainees
• Review

3
IMCI adaptation

• Select the first districts for IMCI
  implementation
• Assess drug availability and make necessary
  improvements
• Update existing health messages to address IMCI
• Ensure sustainability of the strategy, including
  collaboration with partners
• Relate IMCI to existing child health activities
  (e.g. CDD/ARI/breastfeeding)

4
What has been achieved?

• Status to Date

5
Implementation of IMCI
Early 1996 14 Countries
Nepal
Philippines
Indonesia
Viet Nam
Uganda
Zambia
6
Implementation of IMCI
7
Achievements with IMCI implementation in Africa

• IMCI adopted as regional strategy for child
  health
• 32 countries (of 46) currently implementing IMCI
• 12 countries adopted IMCI as national strategy
  for child health
• manpower capacity available to technically
  support country implementation
• 4000 health workers trained in 15 countries, and
  health worker performance improved
• IMCI introduced in curricula of medical and
  paramedical schools in 4 countries

8
Achievements with IMCI implementation in
Africa(contd.)

• Evidence that IMCI can serve as catalyst for
  specific health system improvements (drug
  availability, district supervision, organization
  of services)
• IMCI included in WB supported projects in 7
  countries
• 7 countries initiated the planning for the
  community component
• Guidelines for counselling of caretakers adapted
  in 15 countries

9
Challenges to IMCI implementation

• increasing resources in countries to expand IMCI
• expanding in scope and coverage without loss of
  quality
• strengthening the family and community component
• coordinating the implementation of integrated
  strategies (IMPAC and IMCI)
• adapting IMCI to areas of high HIV/AIDS
  prevalence
• establishing and using links with other
  initiatives (e.g., Roll Back Malaria) and
  strategies (e.g., IMPAC)
• incorporate IMCI strategy into HSR

10
IMCI is not Just Another Vertical Programme"
Case management guidelines and training
for individual diseases
Integrated case management guidelines,
training and follow-up
Health worker skills
IMCI brings it all together
Interventions to improve family
and community practices
Health education activities for individual
diseases
Family and community

Drug supply and management
District level management of health services
Health system
Health system development